Concurrent poststreptococcal acute glomerulonephritis and Schönlein-Henoch purpura

A 5-year-old Japanese boy developed concurrent poststreptococcal acute glomerulonephritis (PSAGN) and Schönlein-Henoch purpura (SHP). An elevated titer of ASK on admission confirmed the preceding streptococcal infection. Arthritis of the left knee and petechiae on admission were regarded as features of SHP. The presence of SHP was further confirmed by the pathological finding of leukocytoclastic vasculitis in the skin. PSAGN was strongly suspected due to the findings of microscopic hematuria and hypocomplementemia in the acute phase. The concurrence of SHP and PSAGN suggests similar underlying pathophysiological processes as poststreptococcal sequelae. At the height of the illness, peripheral blood lymphocyte subset analysis showed a marked increase in the suppressor inducer T subset and a reciprocal decrease in the helper T subset. This alteration in T lymphocyte subsets was regarded as indicative of the immunological derangement in this patient.